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Secondary Bacterial Infections – Ear Infections

In my first blog post, I discussed what the common cold was and how it’s usually managed. I also described the normal course for these viral infections. In this next series, I will address what physicians call a “secondary bacterial infection.” Secondary bacterial infections are a concern when your child’s cold doesn’t seem to follow the expected course.

These infections include bacterial complications of colds such as ear infections, sinus infections, and pneumonia. While most children with colds do not develop bacterial infections, their management is different and usually requires a visit to the doctor to determine the best treatment options. For instance, your doctor can help decide if antibiotics are appropriate or not. Remember, the first clues that your child’s cold may have led to bacterial infection are worsening fever, fevers for more than 5 days, or increasingly sick appearance of your child after the first 2 days of a cold.

Let’s start with ear infections.

Bacterial ear infections are the most common complications of colds, occurring in up to one-third of children with colds. They happen more often in younger children and toddlers, aged 6 months through 4 years, due to the anatomy of their ear canals. Ear infections become less common as children get older. Additionally, frequent ear infections do not typically indicate that there is something wrong with your child’s overall health or immune system. If you are concerned about this, you should ask your doctor about your child’s next visit.

When ear infections develop, they often appear 3 to 5 days after cold symptoms start, or as cold symptoms start to improve. They may, however, appear earlier in the course of your child’s cold. Children tend to develop sudden onset of ear pain and often new fevers over 100.5 degrees. A quick trip to the doctor’s office for an examination can reveal whether or not your child has an ear infection requiring antibiotics. If antibiotics are prescribed, be sure to complete the entire course. Proper treatment can help prevent some rare but serious complications of bacterial ear infections.

In older children, the body is often able to clear the infection on its own without antibiotics. Avoiding unnecessary antibiotic use can be beneficial in many ways including limiting your child’s risk of side effects (such as diarrhea, rashes, yeast infections, and allergic reactions to name a few) and preventing your child from developing a bacterial infection with resistance to antibiotics. Your doctor will help decide the best course of action if an ear infection is found.

Regardless of whether or not antibiotics are prescribed, treating the pain with acetaminophen or ibuprofen is the best first step in managing any ear infection. Ibuprofen is oftentimes more helpful in relieving pain. Be sure to check with your physician about appropriate dosing. Also remember that, at the beginning of your child’s cold, even though they may have ear pain, there might not be a bacterial ear infection present and antibiotics may not be prescribed. This can possibly change however, so it’s important to remember to monitor your child for worsening pain and new, high, or persistent fevers.

Important points to remember about ear infections:

  • Most ear infections start off with viral colds
  • Antibiotics may not always be recommended, but if they are, be sure to complete the entire course
  • Treating the pain with ibuprofen or acetaminophen is very important
Haley Pledger, PA
Women’s Care
Matthew Walton, DO
Austin Bills, DO
Family Medicine
Aaron Fausett, PA
Family Medicine
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